Each month we try to share with readers different types of exercise and the reasons why we as diabetics need to exercise. This month we are at it again. We are going to give you the proverbial pep talk about getting into a program that you can stay with. We suggest that if you get inspired, a visit to your doctor should come first. So let's begin.
In the past, we have asked you to exercise to protect your vascular system, blood pressure and neurological functioning. Today, we want to bring you a report from HHS Secretary Tommy G. Thompson because it really hits home for all of us who need to work to support ourselves and our families. This report underscores the importance of physical activity in preventing disease, and outlines the physical and financial costs associated with a sedentary life including a cost of $117 billion annually associated with being overweight and obese. In the first year after being diagnosed with type 2 diabetes, medical costs are more than twice than for those without this diagnosis. This trend continues for the 8 years of the studies. The government assessment of the medical costs of diabetes is $100 billion a year.
The report states that 300,000 people die each year from diseases and health conditions related to a sedentary lifestyle, and poor eating habits. This is nearly as many as those who die from smoking. The report correlates inactivity and poor health, especially the onset of diseases like diabetes, obesity, and heart disease. For a person with diabetes the following statistics are very important. Millions of Americans suffer from chronic diseases that can be prevented or improved through regular exercise or physical activity: 12.6 million have coronary heart disease, 1.1 million people have a heart attack each year; and nearly 17 million people have diabetes, of which 95% have type 2 diabetes In addition, nearly 50 million adults between 20 and 74 are obese, and more than 108 million (61 %) are either obese or overweight.
Secretary Thompson wants Americans to understand the financial impact and the health costs that inactivity costs in individuals' lives. He also wants us all to understand that there is something we can do to improve our bottom line in terms of income and health.
It is estimated that $103 billion dollars of our medical dollars are spent annually on complications due to obesity, which includes diabetes. For each family, this means health insurance premiums, days lost from work, child care, nursing care and inability to financially plan for the future. These costs are above and beyond the costs listed above. They come out of your pay check, annuity payment, or dividends. Staying healthy is a first step to security.
Particularly alarming are increases in the percentages of young people who are overweight. For example, the percent of adolescents aged 12-19 who are overweight has almost tripled in the past 20 years. By maintaining a healthy weight, more young people would be able to avoid negative behaviors that can lead to psychiatric problems. In fact, studies show that participation in physical activity and sports can increase self-esteem, reduce anxiety and stress and promote social well-being among young people. If you are not sure that this is true, watch teens and the magazines they read and their idols. The people they want to emulate are busy, thin, talented young people, not couch potatoes.
If you think because you are an older reader that you are exempt from this study, you are wrong. This HHS report found that frail health, often associated with aging, is in large part due to physical inactivity. The report cites that although the benefits of physical activity increase with more frequent or intense activity, even moderate levels of activity, such as raking leaves or washing a car, can produce substantial benefits. These benefits can include preventing or delaying chronic diseases such as heart disease, diabetes and high blood pressure, as well as reducing the risk of colon cancer and improving the ability to function for people with arthritis and lung disease. To get personal, let me tell you about my father, who exercised every morning for as long as I can remember. At 83 years of age he drove his block long car to his office, chatted with his staff, and was a successful businessman. This was a gentleman who had suffered cancer, heart disease, and ulcers, but who woke up after his first heart attack and decided to change his lifestyle. The weekend before he entered the hospital for his final stay, he danced at my stepmother's birthday dinner dance. He would have been the first to share that when he changed the way he ate and took care of himself, his ability to enjoy life also changed for the better. The man who was given up for dead on my 16th birthday, lived until his grandchildren married and started to have children of their own, an extra 40 years.
The HHS report states that older people should not fall into the mindset that aging means an automatic stage of inactivity and sitting in a rocker on the porch. As we have shared many times, even moderate exercise can make a real difference. For older people it is recommended they try to do 30 or more minutes of physical activity on five or more days a week. It is estimated 28-34 % of those 65-74 years of age and 35-44% of those 75 years and older are inactive. To make matters more complicated, it is thought that by 2030, the number of older Americans is expected to double from 35 million to 70 million. Currently almost one-third of the total U.S. health expenditures are for older people.
Have we converted you or at least gotten you to think about exercise? Let us share one more fact about diabetes and thought processes concerning life. A recent study indicated that people with diabetes around the world think that they can not stop the progress of the diabetes. They use this thought process to not care for themselves properly. As a person with type 1 diabetes, I certainly understand the pessimism that surrounds us at times. Going to the doctor after having diabetes for a number of years, it is a toss up as to which complication will show itself, even if just slightly. The first thought is "why continue with the exercise, diet, pump etc?" The second is always the same. Without the hemoglobin A1c of 6%, the exercise, the pump, the healthy food, I wonder how much sooner I would have developed the complication and how much worse it would be. I know I feel better about myself because I am in control, not the diabetes, and I like that feeling. Exercise is a large part of my program. I can't say I'll try anything because I won't, but if it looks like fun to me; I'm game. The old saying is true. When you have lemons; make lemonade.
If you have type 2 diabetes, exercise has been shown to help in the prevention of cardiovascular disease, especially if you have insulin resistance. This insulin resistance is an important risk factor for premature coronary disease, particularly with concomitant hypertension, hyperinsulinemia, central obesity, and the overlap of metabolic abnormalities of hypertriglyceridemia, low HDL, altered LDL and elevated FFA. Most studies show that these patients have a low level of fitness compared to controls even when matched for levels of ambient activity, and that poor aerobic fitness is associated with many cardiovascular risk factors. Improvement in many of these has been linked to a decrease in plasma insulin levels, and it is likely that many of the beneficial effects of exercise on cardiovascular risk are related to improvements in insulin sensitively.
There is evidence linking insulin resistance to hypertension in diabetic persons. Effects of exercise on reducing blood pressure levels have been demonstrated.
Regular exercise has consistently shown to be effective in reducing the levels of triglyceride-rich VLDL.
Data have accumulated suggesting that exercise may enhance weight loss and in particular weight maintenance when used with an appropriate calorie-controlled meal plan.
A great deal of evidence has been accumulated supporting the hypothesis that exercise, among other therapies, may be useful in preventing or delaying the onset of type 2 diabetes.
Type 1 diabetics can participate in all leisure, recreational sports and competitive professional activities. The rules that we have listed many times on this site are important in terms of knowing how to avoid hypoglycemia and when to exercise if blood glucose levels are high. Avoid exercise if fasting blood glucose levels are > 250 mg/dl and ketosis is present or if glucose levels are > 300 mg/dl, irrespective of whether ketosis is present. Always eat carbohydrates if glucose levels are <100 mg/dl before exercising.. Eat added carbohydrates as needed to avoid hypoglycemia, and have carbs readily available during and after exercising.
It is known that diabetes is associated with increased risk of macrovascular disease, so that the benefit of exercise that improves the risk factors for atherosclerosis is highly valued. This is particularly true in that exercise can improve the lipoprotein profile, reduce blood pressure, and improve cardiovascular fitness. For the type 1 diabetic, the emphasis is on adjusting the therapeutic regime to allow for safe participation in all forms of physical activity consistent with each person's goals. To that end, since developing diabetes, this person has continued to ski both Alpine and cross country, mountain climb, play tennis, walk, jog, run, and participate in all sorts of water sports, aerobics, body sculpture, and then try yoga, tai chi, and just about anything that has come along. Just read the monthly exercise articles and you'll get an idea of what I've tried and which exercises I continue to love. Daily exercise keeps my heart healthy, blood pressure controlled and me in a size 6. It has been my friend when loved ones are sick enough to warrant hospitalization, and helped me get through the losses of parents. So, dear readers, if the health aspect doesn't pique your interest, reread the beginning of this article and think about your bank statement and your family. Then see your physician and get moving. Summer time is an excellent time to leave those reruns on TV and get into a fitness program. You'll find it addictive to feel good.
BSP
